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HOW MIND CONSULTANCY WORKS


Techniques and theories

 

 

Although there exists a profusion of theories, or 'schools', of psychotherapy, none is more likely than another to help a person cope successfully with functional mental disorder!(1)   Because no two people are the same, standardised forms of help cannot work for everyone and the process needs to be designed to meet the particular needs of every client.   Pace Sigmund Freud, psychotherapy, whatever its form, is a craft, not a science.   

Some of the schools include:
'art therapy', 'cognitive/behavioural', 'eclectic', 'existential', 'family', 'Gestalt', 'group', 'hypnotherapy', 'Jungian', 'music therapy', 'neo-Freudian', 'personal construct', 'psychodynamic', 'psychodrama',  'rational-emotive therapy', 'Rogerian' and 'transactional analysis'.   Others make use of such techniques as 'biofeedback', 'desensitisation', 'dream analysis', 'guided imagery' and ' paradoxical intention'.   Almost every day seems to spawn a new school or technique!

Although mind consultants may suggest using these techniques if they seem likely to help in some way, assertions that a long training in any of them ensures a consultant's competence and trustworthiness are misleading and irresponsible.   

 

'Non-specific' factors

 

Since 1936 at least, reputable psychotherapists have acknowledged that the most efficacious factors for achieving a satisfactory outcome are ‘non-specific’ and common to all the 'schools'.(2)   'Without your help, I could never have made it this far'. ©Hallmark Cards Inc.These include clients' belief that mind consultancy will help them, their readiness to help themselves, the quality of the client-consultant relationship and exclusive attention by consultants to the needs expressed by their clients
 

Client factors

 

The readiness of clients to help themselves depends on:

their circumstances;

their confidence in the mind consultant and the process;

support from family, friends, colleagues and so on; 

their natural resilience to setbacks.(3)  

Another important factor is clients' 'world-view'; their mental picture of their social environment and how they fit into it.   

Attempts by a consultant to help and encourage clients will achieve a satisfactory outcome only if their clients are prepared to practise what they discover from working with the consultant. 

 

'Therapist factors

Almost as important is the ability of consultants to foster a conducive working relationship, or ‘therapeutic alliance’.   The quality of that alliance is largely determined by the consultants' interpersonal, or ‘people’, skills — such as:  

understanding the real person behind the client’s status, appearance, manner, expressed beliefs; 

imagining themselves in the client’s situation; 

genuinely understanding what their client is struggling to communicate and demonstrating it by the responses that they make;

dedicating themselves to discovering clients' real needs, to offering appropriate help and offering such emotional support as seems to be needed.

 


 The following statements indicate what clients may expect from  their consultants.   

 

'The attitude of the psychotherapist is infinitely more important than the theories and methods of psychotherapy'. Carl Gustav Jung(4)

'Experience has taught me to keep away from therapeutic 'methods' as much as from diagnoses ... everything depends on the man and little or nothing on the method.' Carl Gustav Jung
(5)

'.. however much therapists may focus on the technical aspects of their procedures, an increasing body of evidence suggests that it is the personal relationship between themselves and their patients which is experienced by the latter as the most potent therapeutic force.' David Smail
(6)

'Some years ago I formulated the view that it was not the special or professional knowledge of the therapist, nor his intellectual conception of therapy (his 'school of thought') , nor his techniques which determine his effectiveness. I hypothesised that what was important was the extent to which he possessed certain personal attitudes in the relationship.' Carl R. Rogers(
7)

'... the crucial factor in psychotherapy is not so much the method, but rather the relationship between the patient and his doctor or, to use a popular expression the 'encounter', between the therapist and his patient.   This relationship between two persons seems to be the most significant aspect of the therapeutic process, a more important factor than any method or technique.' Victor E. Frankl
(8)

'Experience provides clinicians with a special sense of what should be done next in (psycho)therapy: on a deep level, this special sense reflects a very complex decision-making process that is informed by dozens, perhaps hundreds, of bits of data related to the client, the therapist and the context.' John D.W. Andrews, John C. Norcross & Richard P. Halgin
(9)

'If any single fact has been established by psychotherapy research, it is that a positive relationship between patient and therapist is positively related to therapy outcome.' Irvin D. Yalom
(10)

'A psychoanalyst's personality is his major therapeutic tool. Henri F. Ellenberger
(11)

'If I can only be myself in the relationship, not a professional expert, not a "psychologist", not a "psychotherapist", just me in that relationship, that's helpful.' Carl R. Rogers
(12)

'... we are only more helpful than the average layperson because of our greater experience of people in distress ... rather than because of our extensive knowledge of psychodynamic/humanistic theory and practice ...   By simple virtue of being professionals, we may be seen as knowing best — and we may come to believe in this myth ourselves, perhaps setting great store by psychodynamic formulations rather than being a fellow pilgrim with our clients ...' Gill Edwards
(13)

'There is growing evidence that effectiveness in therapy is primarily dependent on the quality of the relationship between therapist and patient and that that, in turn, depends on the quality of the therapist.   The results of psychotherapy are, however, difficult to assess, especially since many or most of the conditions treated naturally improve with time.   There can be little doubt that many people can benefit greatly from wise and considered counselling by an educated and experienced life-guide.   Whether there is any school of psychotherapeutic training which can produce such qualities is another matter.' Robert M. Youngson (ed.)
(14)


'... it is becoming increasingly obvious that the (psycho)therapist's personality is a more decisive factor than the school to which he belongs. Arthur Koestler(15)

 

           . . . and, in order to get maximum benefit from the consultancy, clients should be ready to answer such questions as:

               1. What is troubling me?
               2. What is troubling me most at present?
               3. What am I trying to do about it?
               4. What progress am I making?
               5. What seems most likely to help?
       

 

References:

(1) L. Luborsky, B. Singer & L. Luborsky: 'Comparative studies of psychotherapies: is it true that "everybody has won and all must have prizes"?' pp 995-1008 Archives of General Psychiatry 32 (1975); D.A. Shapiro & D. Shapiro: 'Meta-analysis of comparative therapy outcome studies: a republication and refinement' pp 581-604 Psychological Bulletin 92 (1982)"
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(2) Saul Rosenzweig: 'Some implicit common factors in diverse methods of psychotherapy' pp 412-415 American Journal of Orthopsychiatry 6 (1936) and ) G. Watson: 'Areas of agreement in psychotherapy' pp 698-709 American Journal of Orthopsychiatry 10 (1940)
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(3) Michael J. Lambert 'Psychotherapy outcome research' pp 94-129 in Handbook of Psychotherapy Integration [John C. Norcross & Marvin R. Goldfried (eds)] Basic Books, New York 1992
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(4) p. 281 Modern Man in Search of a Soul. Routledge & Kegan Paul, London 1933
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(5) 'The Realities of Practical Psychotherapy' p. 329 in The Practice of Psychotherapy  Routledge & Kegan Paul, London 1966
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(6) p. 49 Illusion and Reality  J.M. Dent & Sons, London 1984
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(7) p. 81 Person to Person (co-author B. Stevens)  Souvenir Press, London 1973
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(8) p. 137 Psychotherapy & Existentialism   Penguin, Harmondsworth 1973
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(9) 'Training in psychotherapy integration' pp 576-577 in Handbook of Psychotherapy Integration [John C. Norcross & Marvin R. Goldfried (eds)] Basic Books, New York 1992
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(10) p. 401 Existential Psychotherapy   Basic Books, New York 1980
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(11) p. 48 The Discovery of the Unconscious. Basic Books, New York 1970
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(12) Interviewed by Tony Hobbs ['The Rogers Interview' Changes  vol. 4, no 4, 1986, p. 255]
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(13) p. 22 Changes  vol. 3, no 1 (1984)
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(14) p. 670 Encyclopedia of Family Health  The Royal Society of Medicine, London 1995
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(15) p. 248 The Act of Creation   Hutchinson & Co., London 1964
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SUGGESTED READING:

L. Luborsky, B. Singer & L. Luborsky: 'Comparative studies of psychotherapies: is it true that everyone has won and all must have prizes?' pp 995-1008 Archives of General Psychiatry  32 (1975)

Hans Strupp & Suzanne Hadley: 'Specific versus non-specific factors in psychotherapy' pp 1125-1136 Archives of General Psychiatry  36 (1979)

D.M. Stein & M.J. Lambert: 'On the relationship between therapist experiences and psychotherapeutic outcomes' pp 1-16 Clinical Psychology Review  4 (1984)

J.A. Hattie, C.F. Sharpley, H.J. Rogers: 'Comparative effectiveness of professional and paraprofessional helpers' pp 534-41 Psychological Bulletin  95 (1984)

D. E. Orlinsky & K.I. Howard: 'Process and outcome in psychotherapy' in Handbook of Psychotherapy and Behaviour Change   S. L.Garfield & A.E. Bergin (eds) 3rd edition, Wiley New York 1986 

The Heart and Soul of Change: What Works in Therapy  by Mark A. Hubble, Barry L. Duncan, Scott D. Miller. American Psychology Association, Washington DC 1999

The Great Psychotherapy Debate  by Bruce E. Wampold. Lawrence Erlbaum Associates, Mahwah, New Jersey 2001

The Heroic Client: A revolutionary way to improve effectiveness through client-directed, outcome informed therapy  by B. Duncan, S. Miller, J. Sparks, G. Jackson, R. Greenberg, K. Kinchin.  Jossey Bass, San Francisco 2004

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For more information, without obligation, telephone: 01773 833267 (24 hours). All calls are confidential.